Abstract Details

Title Double Inversion Recovery Is Sensitive in Detecting Small Cortical Ischemic Brain Lesions

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 158

Objective

Background BACKGROUND: After carotid artery stenting (CAS) diffusion-weighted imaging (DWI) can display restricted lesions (DWIrls) mostly located in cortical borderzones. Follow-up magnetic resonance (MR) may not track the lesions early detected by DWI. Double inversion recovery (DIR) MR sequence selectively images gray matter by suppressing the signals from white matter and cerebrospinal fluid. DIR is widely used to investigate intracortical lesions in Multiple Sclerosis.

Design/Methods DESIGN/METHODS: Ten consecutive patients affected by severe carotid stenosis underwent MR evaluation with Fluid attenuated inversion recovery (FLAIR) and DWI with ADC maps before (E0) and after (E1) CAS. Follow-up MR was performed within 24 months (E2) collecting DWI, FLAIR and DIR sequences. On E1 scans DWIrls were picked out and their evolution on the FLAIR and DIR E2-scans was evaluated. This study was approved by the local institutional review board. All patients gave their informed written consent.

Results RESULTS: Eight small cortical DWIrls were found at E1. We observed three different MR evolution paradigms of DWIrls on E2-scans: a) hyperintense areas detectable both by DIR and FLAIR; b) hyperintense areas detectable by DIR but not by FLAIR; c) no lesions detectable either by DIR or by FLAIR.

Conclusions CONCLUSIONS: DIR is sensitive in detecting cortical ischemic lesions and may identify small intracortical lesions barely detectable or not detectable by FLAIR. DIR application could accurately define the cortical ischemic micro-damage in patients undergoing CAS.

Authors/Disclosures
Doriana Landi PRESENTER	Doriana Landi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Doriana Landi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Doriana Landi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis Italia. Doriana Landi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Doriana Landi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen Italia. Doriana Landi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Teva. The institution of Doriana Landi has received research support from Italian Ministry of Health.
	No disclosure on file
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	No disclosure on file
Gabriele C. De Luca, MD, DPhil, FRCPath, FAAN (University of Oxford)	Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurology Academy. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. De Luca has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wellcome Trust. The institution of Dr. De Luca has received research support from National Health and Medical Research (Australia). The institution of Dr. De Luca has received research support from UK MS Society. The institution of Dr. De Luca has received research support from Oxford-Quinnipiac Partnership. The institution of Dr. De Luca has received research support from US Department of Defense. The institution of Dr. De Luca has received research support from National Health and Medical Research (Australia). The institution of Dr. De Luca has received research support from Rosetrees Trust. The institution of Dr. De Luca has received research support from Strategic Innovation Fund, Oxford University. The institution of Dr. De Luca has received research support from Agence National de la Recherche. Dr. De Luca has a non-compensated relationship as a Editorial board member with MS Journal that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Steering Group member with MS Academy that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Board of Directors with SEQUINS that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Editorial board member with Continuum (AAN) that is relevant to AAN interests or activities. Dr. De Luca has a non-compensated relationship as a Editorial board member with Frontiers in Neurology that is relevant to AAN interests or activities.
	No disclosure on file
	No disclosure on file
Marco Fiorelli, MD	No disclosure on file
	No disclosure on file
Fabrizio Vernieri	No disclosure on file